French M T
Department of Epidemiology and Public Health, University of Miami, Miami, Florida 33136, USA.
Recent Dev Alcohol. 2001;15:209-28. doi: 10.1007/978-0-306-47193-3_12.
The objective of this paper is to summarize and critically review the most recent literature on economic evaluation of alcohol treatment services, identify information gaps, and suggest a research agenda for the future. The focus of the review is research published after 1995, although some of the earlier economic studies are also included. Research findings in the literature provide evidence for the following. First, for many alcoholics, day hospital treatment or even less intensive outpatient services are cost-effective alternatives to inpatient treatment. Second, alcoholism treatment often results in declining health care costs for alcoholics who are covered by private health insurance. Third, though the use of alcoholics anonymous (AA) as an alternative to more structured alcohol treatment services may be cost-effective, substance abuse outcomes from AA are sometimes less favorable and the risk of relapse is higher. Fourth, methods have recently been developed to estimate the dollar value of alcohol treatment outcomes such as avoided absenteeism, increased productivity, improved health, and avoided crime. Based on these findings and developments, new treatment approaches and changes in service delivery systems require a fresh perspective on the costs and benefits of alternative treatment services. The findings from economic evaluation studies must be reported in clear and nontechnical terms to an audience of clinicians and politicians so that they can be used in the process of decision making.
本文的目的是总结并批判性地回顾关于酒精治疗服务经济评估的最新文献，找出信息差距，并提出未来的研究议程。尽管也纳入了一些早期的经济研究，但本次综述的重点是1995年以后发表的研究。文献中的研究结果为以下内容提供了证据。第一，对于许多酗酒者来说，日间医院治疗甚至强度更低的门诊服务是比住院治疗更具成本效益的选择。第二，酗酒治疗通常会使参加私人医疗保险的酗酒者的医疗保健成本下降。第三，虽然将匿名戒酒会（AA）作为更结构化酒精治疗服务的替代方案可能具有成本效益，但AA的药物滥用治疗效果有时不太理想，复发风险更高。第四，最近已开发出一些方法来估算酒精治疗成果的货币价值，如避免旷工、提高生产力、改善健康状况以及避免犯罪。基于这些发现和进展，新的治疗方法和服务提供系统的变化需要对替代治疗服务的成本和效益有全新的认识。经济评估研究的结果必须以清晰且通俗易懂的语言报告给临床医生和政治家，以便在决策过程中加以利用。
